Considering leaving hospital after new grad internship

  1. 3
    Hi all. I finished nursing school in May 2011 in California and have been looking for a job as a new grad RN, which as all new grads know has been really difficult in this economy. Before I did my RN program, I worked in the home health setting for a couple of years as an LVN. I worked as a private duty nurse and my patients needed more help with ADL's than serious medical treatment. Since the job market is so terrible in California for new grad RN's, I've been looking all over the country.

    I was accepted into a new grad internship in the midwest, so I moved across the country by myself for this 13 week internship in MedSurg. The pay is very low compared to California (less than $20 an hour). But honestly, I don't care much about the pay- I feel like I needed the experience and it's been awhile since I've been in the hospital setting so I thought it would be good for me. I did not sign any contracts with the hospital since there's not a guarantee of a job after the internship, but I think they intend to offer a job if I do well since they are training me. I'm in the Float Pool right now and doing classroom training and working with preceptors on the Med Surg unit.

    My main concern right now is that after being in a hospital setting on the unit, I feel so uncomfortable and like it's not the right place for me. It is very different than home health and the nurses here have 8-10 patients. It is so stressful and chaotic and I feel completely overwhelmed. Every day I come home so stressed out and overwhelmed. Honestly, I never really wanted to work in the hospital setting but many jobs I've applied for all want a year of acute care experience. I felt like maybe this is something I need to do to get that experience and then move onto an area outside of the hospital (like community health, outpatient clinic setting, etc.) The patients are so acute in the hospital and I'm not used to dealing with so many time management issues, and knowing how to treat these patients. It's so fast paced and I feel lost. The other interns in my class seem to all enjoy the challenges and the fast pace, but I feel overwhelmed and like I really don't want to be there! I know everyone says your first year in nursing is the most stressful, but I wonder if some people are just not cut out for floor nursing. I felt very confident and happy working in home health, but feel completely the opposite on the Med Surg floor.

    Part of these feelings may be emphasized by feeling homesick- I really miss my family and friends and lifestyle in California (and the mountains!). I am 3 weeks into the 13 week internship, and I do intend to stay for the internship because I DO want to learn more clinical skills and grow as a nurse. But honestly, I really don't think I want to work in a hospital setting. My question is- if I left after the internship, do you think I could possibly get a nursing job in another area (outside of the hospital) and the internship would be valuable experience? Or do you think employers would frown upon leaving after an internship? I think if the hospital offers a permanent job on a unit (not on float pool) after the internship, we have to sign a year contract.

    My question is- if hospital nursing is something I really don't want to do, should I leave after the 3 month internship and just put the internship on my resume, or try to stick it out for a year for the experience and just be really stressed out and unhappy? I can do it if I really have to, but if the hospital setting is not really what I want, is it really necessary? I want to do the right thing, and feel so confused right now. I don't know if it's worth the mental stress and also the risk of losing my license. (I have heard on the night shift that they sometimes have up to 12 patients, which really doesn't seem safe to me for any nurse- let alone a new grad!) I would really appreciate any advice! I don't want to keep bouncing around from job to job, but it is really important for me to find an area of nursing that I can do well in and have some enjoyment. I just really don't think it's in Med Surg!
    JustJane2008, lindarn, and Joe V like this.
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  3. 45 Comments so far...

  4. 14
    Tough call. But really, what you're seeking is permission to quit once the internship is over, bottom line. What I mean is, you KNOW you don't want to work in the hospital, and have all sorts of reasons for leaving, but you would really like other nurses to tell you it's ok, just leave.

    I'm not so sure. See, the thing is it is STILL going to be hard for you to find a job without the experience....and a 13-week internship won't count. It definitely won't be "valuable" for your resume. Actually, you should keep in mind that a potential employer could see your leaving after another employer spent $$ on your internship and then you QUIT as a problem....so it might not be in your favor for anyplace EXCEPT the hospital that spent the $$ training you.

    Yes, it's possible that I'm completely wrong, that a future employer won't care that you left after the orientation/internship. But I don't think so.

    So, back to the crux of the problem: you don't want to work in the hospital setting, but you don't have the experience needed to work outside of it. What do YOU think you should do?

    Of course no one wants to see you miserable, but be very honest with yourself and think about how much of your unhappiness is caused by the job itself, or the location (away from your hometown).

    It's true med-surg isn't for everyone, that's NO DOUBT. Some love it, some hate it, but if nothing else, it's gonna teach you a TON, to give you experience that IS valuable. Oh, and another thing: if I had a buck every time I heard "but I could lose my license" or "I'm not risking my license"....it takes danged near an act of G-d for anyone to ACTUALLY lose a license because of heavy patient assignments. It's something everyone fears, nearly everyone shouts about at one time or another, but it's a rarity of rarities.

    So.....looks like you have some thinkin' to do.....and I do wish you the BEST in figuring it out! At least you have ten more weeks to do it
    SE_BSN_RN, Catzilla, sherdk, and 11 others like this.
  5. 3
    I'm not happy about our pt ratios either but I'm gonna tough it out for a year and then look for better opportunities. That magic number of one year experience seems to be a huge deal, once that is over i believe we can begin looking at moving to just about anywhere we want. Learning to manage time is a huge place for new nurses to get skilled in the first year on the floor and in my case it is in a 5:1 pcu setting. Very unnerving but very doable.
    perioddrama, opossum, and lindarn like this.
  6. 10
    RNsRWe, you are so much nicer than I am. I, for one, was angry at this post. My question is if you liked home health and you have experience in home health, why did you take an internship in a hospital? I am surprised they picked you since you technically do have experience, even if it is as a LVN. There are RN jobs in home health and you could have had not too bad of a time finding one since you have experience in it. It makes me angry you took a spot that could have been given to someone who wanted that and to work there. Plus, internships cost money (now, I said in another thread that money shouldn't matter if there's threatening and discord being created on purpose but that doesn't seem to apply here). Also, if you know now you don't want to stay and want to quit, then why not do it now?

    Shew, I will now step off my soap box...before you quit, maybe you should ask a fellow intern or preceptor for tips on time management.

    My apologies if I was too rough.
    CP2013, SE_BSN_RN, joanna73, and 7 others like this.
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    Did you try applying to a home health position as an RN? Since you have LPN experience, I don't understand why they wouldn't hire you...or did you want to try the hospital setting, first?

    The first year of nursing *IS* hard...there is so much that is learned on the job, not really in school. In school, you have the "perfect" patient (and only one!) and everyone is so nice, everything goes smoothly...but in the real world, that isn't necessarily the case. When I was a new grad, there were many days where I felt discouraged and was under a lot of mental stress. Don't give up! I, too, am homesick. My husband is in the military and we moved from Ohio to Texas, over 1,200 miles away from all of my friends and family. I don't have anyone here except for my husband. I stuck it out, though, and I love my job.

    Personally, I would stick it out, especially in this economy. Having just an internship on your resume may not be enough when you try to find another job. That also might raise questions as to why you just had an internship and no work experience afterwards. Look into how many years you will be committed to the hospital, too. A hospital in my area offers new grad internships but I'm pretty sure you have to sign a contract right off the bat and it's a 2-year minimum work commitment. Even though you didn't sign a contract yet, training new RNs is VERY expensive. The hospital is putting an investment in you. As wish_me_luck stated, maybe someone else really wanted that internship spot that you have because they really want to work at that hospital.

    If you tough it out, you'll have a year or two of acute care experience under your belt. That will open the door for many opportunities in the future. And being in the float pool is great because you will get to experience different units as opposed to just one.
    SE_BSN_RN, lindarn, and GypseyGirl like this.
  8. 1
    I did not mean to offend anyone by my post. I know it's a very tough economy. My classmate from nursing school was offered a job here and I got hired on last minute by the hospital for the internship because they had a spot available. I know it's very tough for new grads to get into internships in California. But I also know a lot of my classmates from California would not be willing to move across the country for an RN job that pays $18 an hour when they have LVN jobs that pay $30 an hour. I heard some hospitals in California are having new grads actually do internships with no pay for the experience, because that's how bad the job market is for new grads.

    I did not want to take any spot from someone else. But I did not have a job when my classmate told me about this internship opportunity, so I thought it would be a good experience for me. I do agree that having a year of acute care experience in a hospital setting will look much better on my resume than doing an internship. I just worry about making medication errors with having so many patients, and also about not having much time to interact with patients. Part of the reason I went into nursing is because I really love having patient interaction and being able to help people. The hospital setting is really different for me from the home health setting because I feel like the focus is more on time management, charting, monitors, equipment, procedures, versus actual one on one talking with patients and having that connection. I feel the role of the nurse in the hospital is so important though. I just don't know if I'll be able to handle the pressure and provide enough patient care. I worry with having so many patients and still being a new nurse that I may miss something and lose a patient because of it. It's not just my own feelings of being stressed. I also worry about having so many acutely ill patient's lives in my hands and wondering if I'm capable of that kind of responsibility. Maybe with time, I will feel more confident and more comfortable. I have had 3 different preceptors on my 3 different clinical shifts, and most of them I was just shadowing and didn't get to do much. Maybe with more hands on experience, I'll feel more confident. But it's just a tough call.

    I did look for home health jobs as RN's but many of them only provided a day of training and they did procedures like wound vacs and antibiotics through PICC lines, and different procedures I've never done in nursing school or in my previous home health jobs. I didn't feel like it would be safe to be on my own in patient's homes without proper training. At least in a hospital, there is more support around if you have questions or need help. I am hoping to figure this out. Just having so many different emotions these past few weeks after moving to a new city and adjusting to the hospital setting. I'm hoping it will get better throughout the training, but just right now feeling very scared of being on my own on the floor
    Meriwhen likes this.
  9. 2
    Okay, I am calm now. I am curious what happened to your home health job as a LVN. But that aside, I understand the economy and everything but I would have done the home health thing even if there was a 1 day orientation and then, if you were given things you don't know how to do, ask about classes or ask if you can have an experienced RN come with you that visit and show you how.

    Oh, and PS--yes, wages are lower elsewhere but 18 dollars an hr some places is an OK wage. Now, you won't be vacationing all the time, but with proper money management, it's okay in places where cost of living is fairly reasonable. Cali. nurses get a lot more because cost of living is much higher.
    CP2013 and GypseyGirl like this.
  10. 0
    I could still go back to my home health LVN job in California. I was making $28 an hour taking care of patients with disabilities in the home setting. I found it rewarding and felt valued for being there, but I also felt like I wasn't advancing since I got my RN license and continued to work for another year as an LVN. It was definitely an area that was comfortable for me, but I felt like I should grow as a nurse and develop more skills. I hadn't really done much clinical skills in home health and wanted more practice with IV's, medications, etc. The hospital is definitely a whole other challenge. Going from 1 pretty stable patient in the home setting to 7 or 8 extremely unstable patients in the hospital setting is definitely a huge step out of my comfort zone. I am trying not to feel too overwhelmed, but it's hard not to feel that way. I will try to take things one day at a time and see how I feel later into the internship. I agree about floating being able to learn a lot, but I think it would be pretty intimidating as a new nurse to be changing floors all the time and have different coworkers, different patients, and a different setting and way of doing things each time I come in. I guess if I can get through it, I would probably come out a stronger nurse. But it's just a matter of getting through it

    And about the salary- I agree. It's all relative depending on where you live. I am single and have no kids or husband or student loans, so I don't necessarily need a lot. Money is always nice, but I care more about being in a job that I enjoy and feel fulfillment from than making a lot of money and being miserable.
  11. 2
    Quote from GypseyGirl
    I did not mean to offend anyone by my post. I know it's a very tough economy. My classmate from nursing school was offered a job here and I got hired on last minute by the hospital for the internship because they had a spot available. I know it's very tough for new grads to get into internships in California. But I also know a lot of my classmates from California would not be willing to move across the country for an RN job that pays $18 an hour when they have LVN jobs that pay $30 an hour. I heard some hospitals in California are having new grads actually do internships with no pay for the experience, because that's how bad the job market is for new grads.

    I did not want to take any spot from someone else. But I did not have a job when my classmate told me about this internship opportunity, so I thought it would be a good experience for me. I do agree that having a year of acute care experience in a hospital setting will look much better on my resume than doing an internship. I just worry about making medication errors with having so many patients, and also about not having much time to interact with patients. Part of the reason I went into nursing is because I really love having patient interaction and being able to help people. The hospital setting is really different for me from the home health setting because I feel like the focus is more on time management, charting, monitors, equipment, procedures, versus actual one on one talking with patients and having that connection. I feel the role of the nurse in the hospital is so important though. I just don't know if I'll be able to handle the pressure and provide enough patient care. I worry with having so many patients and still being a new nurse that I may miss something and lose a patient because of it. It's not just my own feelings of being stressed. I also worry about having so many acutely ill patient's lives in my hands and wondering if I'm capable of that kind of responsibility. Maybe with time, I will feel more confident and more comfortable. I have had 3 different preceptors on my 3 different clinical shifts, and most of them I was just shadowing and didn't get to do much. Maybe with more hands on experience, I'll feel more confident. But it's just a tough call.

    I did look for home health jobs as RN's but many of them only provided a day of training and they did procedures like wound vacs and antibiotics through PICC lines, and different procedures I've never done in nursing school or in my previous home health jobs. I didn't feel like it would be safe to be on my own in patient's homes without proper training. At least in a hospital, there is more support around if you have questions or need help. I am hoping to figure this out. Just having so many different emotions these past few weeks after moving to a new city and adjusting to the hospital setting. I'm hoping it will get better throughout the training, but just right now feeling very scared of being on my own on the floor
    I don't know where you lived in California or where you are in the midwest, but I will tell you that $20/hour goes farther in much of the midwest than $30/hour does in most of California!

    Worrying about missing something, being stressed, time management issues and all of the other complaints you cite are pretty much a part of the new nurse role. You took an internship in the hospital for a reason -- and it seemed like a valid reason. If you quit after 13 weeks, it will look horrible on your resume and may impede your getting another job. Plus, you still won't have hospital experience and as you noted, most out of hospital jobs require hospital experience.

    And if you quit this job, how are you going to pay your bills? Or is that not a concern?
    joanna73 and RockinChick66 like this.
  12. 1
    If you really want to quit, you should do so ASAP so you don't waste your time and the hospitals expense in training you. Just leave it off your resume. I wouldn't hire you if I knew you skipped out after training. Good luck.
    sherdk likes this.


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